High Intake of White Bread Boosts Cardiovascular Disease, De
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Diet may influence the development and progression of chronic diseases. Globally, over the past few decades, the consumption of refined grains and added sugars has increased. Positive associations between higher consumption of refined carbohydrates with high glycaemic load and risk factors for cardiovascular disease have been reported.

Similarly, a finding from an assessment of more than 137,000 people in 21 countries suggests that adults who eat three slices of white bread daily have a significantly increased risk for death from any cause or major cardiovascular disease (CVD) event.

The results showed that people who reported eating at least 350 g (seven servings) of refined grain daily had a significant 29% increased risk of either death or a major CVD event (MI, stroke, or heart failure), compared with those who consumed less than one serving per day (fewer than 50 g) of refined grain after adjustment for multiple potential confounders, according to a report from the Prospective Urban Rural Epidemiology (PURE) study.

The analysis also showed no significant association between levels of whole grains or white rice in the diet and CVD events. Rice was considered a separate grain in the analysis because nearly two-thirds of the PURE study population reside in Asia, where rice is a staple food.

Based on the results, the researchers speculated that possible explanations for their findings are that "varieties of rice such as long-grain rice and especially parboiled white rice may have both a definite glycaemic advantage and an overall nutritional advantage over refined wheat products. Also, depending on the culture and the nature of the rice eaten, rice may be displacing less desirable foods."

In contrast, refined grains undergo "rapid action by digestive enzymes and quick absorption from the small intestines that could lead to an increase in postprandial blood glucose concentrations. The rise in glucose concentrations increases the insulin concentrations, which leads to hypoglycaemia, lipolysis, and the stimulation of hunger and food intake," the researchers wrote.

The findings show that "reduction in the quantity of refined grains and sugar, and improvement in the quality of carbohydrates is essential for better health outcomes, although we do not suggest complete elimination of refined grains," said researchers at the Population Health Research Institute of McMaster University, Hamilton, Ontario.